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Quality and Productivity in Mental Health - Dr Bhaumik

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    Quality and Productivity in  Mental Health - Dr Bhaumik Quality and Productivity in Mental Health - Dr Bhaumik Presentation Transcript

    • Quality & Productivity (QIPP) in Mental Health Dr. Sabyasachi Bhaumik Medical Director, Leicestershire Partnership NHS Trust Honorary Senior Lecturer, University of Leicester
    • THE BACKGROUND
      • History of mental health services
        • Shift towards community based care.
        • Closure of beds
      • NSF (1999)
        • Social inclusion & community based care
        • New specialist teams – AOT, CRHT, PIER etc
        • Evidence based practice
        • Improving access – IAPT
      • New Horizons
        • Prevention & early intervention
        • Interagency working
    • Need for efficiency – why now?
      • Economic downturn & its implications
      • Projected efficiency savings - £15-20bn by 2013/14
      • Implications of zero based budgets
      • Mental health – 13.8% of health budget
      • Direct and indirect costs of poor mental health - £77 bn
    • Threats & opportunities
      • Threats
        • Decommissioning
        • Tendering
        • Competition from other sectors
        • Drive towards value for money – efficiency
      • Opportunities
        • Autism Act
        • National Dementia Strategy
        • Long term conditions
        • MUS
        • GP commissioning
        • PbR
    • QIPP as part of efficiency
      • Drivers for efficiency
        • CIPs
        • Decommissioning
        • PbR
        • Tendering
      • Vehicles for efficiency
        • CQUIN
        • Carepathways
        • QIPP
    • What is QIPP?
      • Q uality
      • I nnovation
      • P revention
      • P roductivity
      • Steered by DoH, National Mental Health Development Unit, Audit Commission, NHS Confederation and Mental health Networks
    • QIPP framework
      • National
        • Indentifying levers & setting the agenda – CQUIN, PbR, services for MUS etc
        • Providing support & advice for change
        • Developing partnerships
        • Co-ordinating programmes of change at scale
      • Local & Regional
        • Redesigning systems & pathways
        • Innovations
        • Sharing of audit data between commissioners and providers
        • Benchmarking and evidence building
    • The main principles underpinning QIPP in mental health
      • Care close to home.
      • Fewer acute beds.
      • Reduced variations in care.
      • Standardization of Care pathways.
      • Early Intervention.
      • Productivity.
    • Three major areas for QIPPMH
      • Supporting improvements in the acute care pathway
      • Out of area placements.
      • Physical / mental health interface – including how mental health can support colleagues working in the acute and primary care sector on areas like tackling medically unexplained symptoms and improving liaison services.
    • Examples of innovative practice
      • Releasing time to care (Rampton Hospital)
        • A series of steps designed by staff within the ward
        • Each step has an incentive for the staff
        • Increase in staff morale
        • Reduction in sickness from 14% to 1.1%
        • More efficient ward means better patient care and patient satisfaction
    • Examples of innovative practice
      • Early discharge
      • Underpinned by productive mental health ward
      • Staff initiated process review
      • Achieved reduction in paper work
      • Improvement in in-patient & community coordination
      • Reduction in readmission rate (400% increase in successful early discharge)
    • Examples of innovative practice
      • Intensive Home Intervention Team (Edinburgh)
      • Problems with high bed occupancy & revolving door patients
      • Resolved through creative IHIT combining the functions of AOT and CRT
      • 60% reduction in bed occupancy
      • 94% user satisfaction
    • Further themes of innovative practices
      • Adult mental health:
        • Bringing NSF teams together
        • AOT for revolving door patients
        • e-prescribing
        • generic prescribing
        • e-communication with GP’s
        • Admin support
      • MHSOP:
        • Long term care model
        • Dementia prescribing with primary care
        • Nurse led cognitive assessment team
    • Further themes of innovative practices
      • CAMHS:
        • Joint working with Paediatricians
        • NWW
        • Mental health care workers with primary care
      • LD:
        • Care pathways and PbR
        • NWW
        • Tiered care model
        • Partnership with voluntary organisations, independent sector and social care services
        • Out of area placements
    • Future
      • Commissioning driven by quality of patient experience
      • PbR for mental health in place by 2013/14
      • GP commissioning in place by 2013
      • Partnerships in service provision
      • Total place
      • Transforming Community Services
      • QIPP is here to stay!!